Wound management system and methods of using

ABSTRACT

A wound management system can comprise a surgically acceptable adhesive disposed over a wound and a surgically acceptable film repositionably disposed over the surgically acceptable adhesive, and methods of managing a wound involving the same.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a Continuation of U.S. patent application Ser. No.14/664,264, filed Mar. 20, 2015, which claims the priority benefit toU.S. Provisional Application No. 61/968,796, filed Mar. 21, 2014, thedisclosure of which is incorporated by reference herein in its entirety.

BACKGROUND

Wound management systems are used to assist in closing and coveringwounds, lacerations, and incisions, for example those caused by surgery.Conventional wound dressings and bandages can be effective in coveringand protecting wounds, may not be effective in sealing and aligning thetissue of the wound or incision. Topical skin adhesives (e.g.,cyanoacrylates) have been employed to seal and align tissue edges inincisions, but may not be sufficient or effective in covering andprotecting the incision. Wound management systems have been proposedwhere a conventional skin adhesive composition is “reinforced” byapplying it over conventional wound dressing materials, such as adhesivetape (e.g., as described in US 2009/0036921), whereby the skin adhesivepenetrates the structure of the tape. The resulting “composite”structure reinforces the skin adhesive and may provide a barrier tomoisture and contamination. However, such “composite” systems arerelatively rigid and tend to be uncomfortable for the patient while thesystem is in place, and may cause additional trauma or discomfort whenit is removed. Further, because such composite wound management systemsadhere strongly to the skin, it is not possible to reposition suchcomposites during application, or as needed during the wound healingprocess. Thus, if a “composite” wound management system is misalignedduring application, or becomes misaligned during use, it may benecessary for it to be removed entirely and reapplied, thereby causingadditional trauma to the wound. Thus, there is a need for a woundmanagement system that addresses these and other problems.

SUMMARY OF THE INVENTION

A wound management system can comprise a surgically acceptable skinadhesive disposed over a wound and a surgically acceptable filmrepositionably disposed over the surgically acceptable skin adhesive.The surgically acceptable adhesive can comprise a cyanoacrylateadhesive, such as at least one of butylcyanoacrylate andoctylcyanoacrylate, and particularly octylcyanoacrylate.

The surgically acceptable film can be in contact with the surgicallyacceptable skin adhesive, and can comprise a first side and a secondside, the first side having a pressure sensitive adhesive disposedthereon.

The surgically acceptable film can comprise a silicone sheet. In someembodiments, the surgically acceptable film can comprise a siliconeadhesive. In other embodiments, the surgically acceptable adhesive canbe an atraumatic adhesive.

In some embodiments, the surgically acceptable film can be formed bydisposing a curable gel or curable liquid over the surgically acceptableadhesive and curing the curable gel or curable liquid into a surgicallyacceptable film. In other embodiments, the surgically acceptable filmcan be permeable to at least one of air, moisture, blood, and woundexudates. In still other embodiments, the surgically acceptable film canbe impermeable to at least one of air, moisture, blood, and woundexudates. In yet other embodiments, the surgically acceptable film canbe semi-permeable to at least one of air, moisture, blood, and woundexudates.

In particular embodiments, the surgically acceptable film can betransparent or translucent. In other particular embodiments, thesurgically acceptable film can be opaque. In yet other embodiments, thesurgically acceptable film can be adapted to change from transparent ortranslucent to opaque.

In some embodiments, the surgically acceptable film can comprise one ormore of silicone, paper, cellulose, microporous material, polyamide,polyacrylate, polyester, copolyester, and fabric. In particularembodiments, the surgically acceptable film comprises silicone. Forexample the surgically acceptable film can have a first surfacecomprising silicone and a second surface comprising other suitablematerials. In still other embodiments, the surgically acceptable film iscomposed primarily of silicone.

In some embodiments, the surgically acceptable film is perforated, andin other embodiments it is not perforated. In other embodiments, thesurgically acceptable film is formed in a pre-determined shape, forexample a shape that is suitable for disposition over particularanatomical features, or suitable for disposition over particular typesof wounds or incisions. In still other embodiments, the surgicallyacceptable film is marked with one or more markings delineating one ormore pre-determined shapes for the film, whereby a physician can morereadily trim the film to a desired shape.

In particular embodiments, the wound management system can furthercomprise an absorbent dressing disposed over the surgically acceptablefilm. In other particular embodiments, the wound management system canfurther comprise at least one topically administrable active agent, forexample, one or more of antibiotics, anti-virals, antimicrobials,moisturizers, vitamins, skin nutrients, beneficial oils, and scarreducing agents. In still other embodiments, the wound management systemcan further comprise both absorbent dressing disposed over thesurgically acceptable film, and at least one of the topicallyadministrable active agents described herein.

A method of managing a wound can comprise applying a surgicallyacceptable skin adhesive to a wound and applying a repositionablesurgically acceptable film over the surgically acceptable skin adhesive.In some embodiments, the method can further comprise curing thesurgically acceptable skin adhesive, wherein the cured skin adhesivedoes not impede the repositionability of the surgically acceptable film.In other embodiments of the method, the surgically acceptable skinadhesive can comprise one or more of butylcyanoacrylate andoctylcyanoacrylate, and in particular can comprise octylcyanoacrylate.

In particular embodiments, the method can comprise contacting therepositionable surgically acceptable film with the surgically acceptableskin adhesive. In other particular embodiments, the repositionablesurgically acceptable film is applied before the surgically acceptableskin adhesive is completely cured. In yet other particular embodiments,the repositionable surgically acceptable film is applied after thesurgically acceptable skin adhesive is completely cured.

In some cases, the repositionable surgically acceptable film is asurgically acceptable tape, dressing, or bandage. In particular cases,the repositionable surgically acceptable film is applied as atransparent or translucent film, and becomes opaque over time. In othercases, the method further comprises applying an absorbent dressing overthe repositionable surgically acceptable film. In some embodiments, themethod further comprises applying a topically acceptable active agent,for example, one or more of antibiotics, anti-virals, anti-microbials,moisturizers, vitamins, skin nutrients, beneficial oils, and scarreducing agents, over the wound.

In some embodiments, the surgically acceptable skin adhesive is appliedfrom a sponge-tipped applicator, a high-density foam applicator, aflocked-tipped applicator, or a silicone-tipped applicator. Inparticular embodiments, the applicator is a blister-sealed applicator.

The method can further comprise repositioning the repositionablesurgically acceptable film after applying the repositionable surgicallyacceptable film.

DETAILED DESCRIPTION

It should be understood that all publications, journal articles,patents, and the like that are mentioned in this specification arehereby incorporated by reference in their entirety and for all purposes.

Unless otherwise defined, all terms used in this specification areintended to have the meaning that a person of ordinary skill in the artwould have ascribed to them at the time of the invention. Certain termshave particular meanings, as follows.

“Repositionable” and conjugations thereof refers to a relationshipwhereby a plurality elements are connected in such a way that at leastone element can be moved in space with respect to at least one otherelement. With respect to the repositionable surgically acceptable film,the term “repositionable” refers to the ability to remove the surgicallyacceptable film, either partially or completely from the wound site andreplace it in a different position or orientation without appreciablyremoving or damaging the surgically acceptable skin adhesive, or causingmore than a de minimus amount of additional trauma to the wound site. Insome embodiments, “repositionable” can refer to the ability of e.g. aphysician to completely remove the surgically acceptable film from thewound site, without appreciably removing or damaging the surgicallyacceptable skin adhesive, or causing more than de minims amount ofadditional trauma to wound site, and completely replacing the originallyapplied surgically acceptable film with another repositionablesurgically acceptable film.

“Opaque” refers to substances that have at least 70% opacity. Thepercent opacity for plastic or polymeric materials can be determined bythe ASTM D1746 Standard Test Method for Transparency of PlasticSheeting, and the opacity of paper materials can be determined by theASTM D589-97(2007) Standard Test Method for Opacity of Paper.

A material is considered “permeable” if the moisture vapor transmissionis at least 301 g/m², for example about 301-800 g/m² when testedaccording to the ASTM E96 Standard Test Method for Water VaporTransmission of Materials.

A material is considered “semi-permeable” if the moisture vaportransmission is about 101-300 g/m² when tested according to the ASTM E96Standard Test Method for Water Vapor Transmission of Materials.

A material is considered “impermeable” if the moisture vaportransmission is less than about 100 g/m² when tested according to theASTM E96 Standard Test Method for Water Vapor Transmission of Materials.

“Butylcyanoacrylate” is sometimes known in the art as “butylcyanoacrylate” and can include any of n-butylcyanoacrylate,iso-butylcyanoacrylate, sec-butylcyanoacrylate, andtert-butylcyanoacrylate, either alone or in any combination, andparticularly n-butylcyanoacrylate.

“Octylcyanoacrylate” is sometimes known in the art as “octylcyanoacrylate” and can include any isomer thereof alone or multipleisomers in any combination, and particularly straight-chainedoctylcyanoacrylate.

One of skill in the art understands that other cyanoacrylates can besubstituted for butyl cyanoacrylate or octylcyanoacrylate provided thatsuch other cyanoacrylates provide acceptable skin adhesive propertiessimilar to those of butylcyanoacrylate or octylcyanoacrylate.

The wound management systems of the present invention can comprise asurgically acceptable skin adhesive disposed over a wound and asurgically acceptable film repositionably disposed over the surgicallyacceptable skin adhesive, Repositionable films can be in any form suchas gauzes, bandages, tape, sheets, and the like, so long as the film canbe repositioned after its initial application. The repositionabledisposition of the film can have a variety of advantages over films thatare not repositionable. For example, because a repositionably disposedfilm is not strongly adhered to the skin adhesive, the resulting woundmanagement system is more flexible (less rigid) than a wound managementsystem in which the film and skin adhesive form an integrated composite(e.g., systems in which the adhesive penetrates the film, therebyincorporating the film within the adhesive). This increased flexibilitysubstantially increases patient comfort and reduces trauma upon removalof the wound management system after wound healing is complete. Also,because the surgically acceptable film component of wound managementsystems of the present invention are repositionable, if the film is notinitially applied in the ideal location, as can happen in emergency orhigh stress situations, then the film can be repositioned to a moreideal location at a later time. Similarly, if the ideal position of arepositionable film changes during the course of wound healing, forexample, because of changes in the wound, it can be repositioned asneeded.

The surgically acceptable skin adhesive can comprise any suitable skinadhesive, particularly a cyanoacrylate adhesive. Any cyanoacrylatesuitable for use as a skin adhesive can be used. In particular, thecyanoacrylate skin adhesive can comprise at least one ofbutylcyanoacrylate and octylcyanoacrylate, and more particularly cancomprise octylcyanoacrylate. The surgically acceptable skin adhesive,such as any of the surgically acceptable skin adhesives describedherein, can be an atraumatic adhesive, for example, a silicone adhesive.Examples of suitable surgically acceptable skin adhesives includeSurgiSeal® and Skinaffix® (both available from Medline).

The surgically acceptable film can be disposed over the surgicallyacceptable skin adhesive. Thus, the surgically acceptable film cancontact the surgically acceptable skin adhesive, although this is notrequired unless otherwise specified.

The surgically acceptable film can be any film that can be used insurgery, and can have any surgically acceptable shape, size, or content,depending on the intended use, size and type of wound to be managed, andother factors understood in the art.

The surgically acceptable film can comprise one or more of silicone,paper, cellulose, microporous material, polyamide, polyurethane,polyacrylate, polyester, copolyester, and fabric. In particular, thesurgically acceptable films can comprise silicone, although noparticular components are required unless otherwise specified. Examplesof suitable surgically acceptable films include Gentac® (available fromMedline).

The surgically acceptable film can be in any suitable form. For example,the surgically acceptable film can be in the form of a sheet, dressing,or tape, although this is not required unless otherwise specified. Inparticular, the surgically acceptable film can be in the form of asilicone sheet. Depending on the intended use, the surgically acceptablefilm can be either perforated or not perforated.

The surgically acceptable film can further comprise a film adhesive,such as a silicone adhesive or a pressure sensitive adhesive. When thesurgically acceptable film has a first side and a second side, apressure sensitive film adhesive can be disposed on the first side. Thefilm adhesive can be an atraumatic adhesive. The atraumatic filmadhesive can be one that does not strongly adhere to the surgicallyacceptable skin adhesive or to the patient's skin, but instead allowsthe surgically acceptable film to be repositioned. Such film adhesivescan be low-tack, reusable, pressure sensitive adhesives, for example,sphere shaped acrylic adhesives such as those used in conjunction withrepositionable articles such as POST-IT® notes. In addition, manysilicone adhesives are repositionable.

The surgically acceptable film can be formed before being disposed onthe surgically acceptable adhesive (e.g., provided as a pre-formed sheetor tape), or can be formed in situ over the surgically acceptable skinadhesive. In the latter case, the surgically acceptable film can beformed by disposing a curable gel or curable liquid over the surgicallyacceptable skin adhesive and curing the curable gel or curable liquidinto a surgically acceptable film.

The surgically acceptable film can be permeable to at least one of air,moisture, blood, and wound exudates, Such film can be useful insituations where it is beneficial to allow passage of at least one ofair, moisture, blood, and wound exudates through the film. For example,when wound healing would be benefitted by allowing wound exudates, suchas puss, to drain from the wound site, a permeable film can bedesirable. Permeable films can include, for example, permeable gauze orpaper, although some gauze and paper can be semi-permeable orimpermeable.

The surgically acceptable film can be semi-permeable to at least one ofair, moisture, blood, and wound exudates. Such films can be useful insituations where it is beneficial to allow limited passage of at leastone of air, moisture, blood, and wound exudate through the film.Semi-permeable films can include, for example, semi-permeable polyamidesor polyurethanes, although some polyamide and polyurethane films can bepermeable or impermeable.

The surgically acceptable film can be impermeable to at least one ofair, moisture, blood, and wound exudates. Such films can be useful insituations where it is beneficial to minimize or prevent the passage ofat least one of air, moisture, blood, and wound exudates through thefilm. For example, when a wound at risk for infection, an impermeablefilm may reduce the risk of infection. Impermeable films can include,for example, silicone or polyurethane, although some silicone andpolyurethane films can be permeable or semi-permeable.

The surgically acceptable film can be transparent or translucent. Insuch cases, it can be possible to observe the wound through thesurgically acceptable film without removing the surgically acceptablefilm. Transparent and translucent films can be made out of anytransparent or translucent material, such as transparent or translucentsilicone, polyurethane, and the like.

The surgically acceptable film can be opaque, in which case the woundcan be concealed, for example, for cosmetic purposes. Opaque films canbe made by adding a surgically acceptable dye to an otherwisetransparent or translucent material, or by using a material that isopaque (e.g., opacifying agents such as inorganic fillers such astitanium dioxide) without the addition of a dye.

The surgically acceptable film can be transparent or translucent whenfirst applied, and then become opaque over time. The color change canoccur, for example, by oxidation of the surgically acceptable film or byreaction of one or more components of the surgically acceptable filmwith wound exudate.

The surgically acceptable film can be provided in a pre-determinedshape, such as a rectangle, square, circle, and the like, or irregularlyconfigured to better conform to the contours of a patient's anatomy. Inaddition or in the alternative, the surgically acceptable film can beprovided with one or more markings delineating one or morepre-determined shapes on the film. The one or more markings can be aguide, allowing the user to easily cut the surgically acceptable filminto one or more of the pre-determined shapes, depending on the intendeduse, the size of the wound, the type of the wound, etc. The surgicallyacceptable film can also be provided partially (e.g., “Kiss Cut”) orcompletely precut, optionally on a release film or liner.

The wound management system can further comprise an absorbent dressingdisposed over the surgically acceptable film. The absorbent dressing canbe any absorbent dressing known in the art, and can comprise, forexample, one or more of textiles, wovens, non-wovens, fabrics, bandages,gauze, and the like.

The wound management system can further comprise at least one activeagent, for example to aid in wound healing. Exemplary active agentsinclude one or more of antibiotics, anti-virals, antimicrobials,moisturizers, vitamins, skin nutrients, beneficial oils, and scarreducing agents. The active agent can be incorporated into one or moreof the surgically acceptable skin adhesive, the surgically acceptablefilm, or a separate active agent containing layer.

In use, a method of managing a wound can comprise applying the woundmanagement system described herein to a wound. For example, a method ofmanaging a wound can comprise applying a surgically acceptable skinadhesive, such as any of the surgically acceptable skin adhesivesdescribed herein, to a wound, and applying a repositionable surgicallyacceptable film, such as any of the surgically acceptable filmsdescribed herein, over the surgically acceptable skin adhesive. Themethod can further comprise repositioning the repositionable surgicallyacceptable film after it is applied.

In many cases, it is advantageous to limit or prevent the surgicallyacceptable skin adhesive from entering the wound, although this is notrequired unless otherwise specified. This can be accomplished, forexample, by drawing skin or other uninjured tissue around the woundtogether before applying the surgically acceptable skin adhesive, byapplying a surgically acceptable skin adhesive that cures rapidly uponapplication so that it does not have time to enter the wound, or byproviding a surgically acceptable skin adhesive with sufficiently highviscosity so as to reduce or eliminate flow of the skin adhesive intothe wound.

The surgically acceptable skin adhesive can be applied over the wound byany method known in the art. Typically, the surgically acceptable skinadhesive will be applied to the wound as a curable liquid or gel. Insuch cases, the curable liquid or gel can be applied by pouring ordropping, such as with a medicine dropper, the curable liquid or gelover the wound. Alternatively, such curable liquids or gels can beapplied with an applicator. Suitable applicators include one or more ofa sponge-tipped applicator, a high-density foam applicator, aflocked-tipped applicator, and a silicone-tipped applicator. Theapplicator can be blister-sealed.

When the surgically acceptable skin adhesive is applied as a liquid orgel that is cured over the wound, the repositionable surgicallyacceptable film can be applied either before or after the surgicallyacceptable skin adhesive is cured. For example, if the repositionablesurgically acceptable film is applied after the surgically acceptableskin adhesive is cured, it can be adapted (e.g., by appropriateselection of film material and/or film adhesive) to provide a relativelyweak, repositionable or removable bond to the cured surgicallyacceptable skin adhesive such that later repositioning of the film ispossible. Similarly, if the surgically acceptable film is applied beforethe surgically acceptable skin adhesive is cured, the surface of thefilm (or film adhesive) contacting the uncured skin adhesive should forma relatively weak, repositionable bond to the skin adhesive, once itcures. As yet another example, the repositionable surgically acceptablefilm can comprise a silicone sheet, or a sheet with a silicone surface,that “wets” the surgically acceptable skin adhesive or the subject in amanner similar to that of a surfactant, thereby repositionably andreversibly attaching to one or both of the surgically acceptable skinadhesive and the skin. In such embodiments, a film adhesive may not berequired to provide a repositionable bond between the repositionablefilm and the skin adhesive. Variations of and alternatives to theseexemplary strategies for preventing integration of the surgicallyacceptable skin adhesive and the surgically acceptable film will beapparent to a person of ordinary skill in the art.

The step of applying the surgically acceptable film can comprisecontacting the surgically acceptable skin adhesive with the surgicallyacceptable film. Alternatively, another material, such as awound-healing layer, an absorbent layer, and the like, can be placedbetween the surgically acceptable skin adhesive and the surgicallyacceptable film.

The method can further comprise applying an absorbent dressing, such asthose discussed herein or others known in the art, over the surgicallyacceptable film.

The method can further comprise applying a pharmaceutically acceptableactive agent to the wound. The active agent can be, for example, one ormore of antibiotics, anti-virals, antimicrobials, moisturizers,vitamins, skin nutrients, beneficial oils, and scar reducing agents. Thewound management system of the present invention can be removed in 5-7days after surgery, or after complete healing (typically about 14 days),but can vary depending on the nature of the wound and the patient.

The wound management system disclosed herein can also be provided in theform of a kit. The kit can contain an uncured surgically acceptable skinadhesive in the form of a liquid or gel, and one or more surgicallyacceptable films. Alternatively, the kit can include an uncuredsurgically acceptable skin adhesive, and a curable liquid or gel thatcan be cured to form a surgically acceptable film. The surgicallyacceptable skin adhesive and film can be one of those described herein,or any other film or skin adhesive that is acceptable for use insurgery. The amount of surgically acceptable skin adhesive andsurgically acceptable film in the kit can vary depending on the size ofwound the kit is configured to treat. For example, a kit for treatingsmall or minor wounds can be provided with relatively small amounts ofthe surgically acceptable skin adhesive and film, whereas kits fortreating major or serious wounds or surgery can be provided with largeramounts of the surgically acceptable skin adhesive and film. example,the amount of skin adhesive can be about 0.1 to 10 mL, including about0.1, 0.5, 1, 2, 3, 4, 5, 6, 7, 8, 9, or 10 mL, inclusive of all rangesand subranges therebetween. The amount of surgically acceptable film caninclude particular non-limiting embodiments that are described in thefollowing examples.

EXAMPLE 1

A subject has a laceration approximately 5 inches long on the abdomen.The skin on the sides of the laceration is pulled together, and anoctylcyanoacrylate skin adhesive is applied over the wound using ablister sealed silicone tipped applicator. The adhesive is cured to sealthe wound. A surgically acceptable skin film, in the form of a 4 inch by6 inch rectangular dressing containing a topical antimicrobial ointmentand low-tack pressure sensitive adhesive, is placed over theoctylcyanoacrylate adhesive. The dressing is repositioned as necessaryto optimally cover the wound. After the wound is healed, the dressing isremoved without disturbing the scar or causing excessive pain to thesubject.

EXAMPLE 2

A subject has an avulsion on the torso with an unevenly shaped skinflap. The skin flap is pulled over the avulsion, and a mixture ofoctylcyanoacrylate and butylcyanoacrylate is applied over the skin flapto seal the wound. A curable silicone gel is applied over thecyanoacrylate adhesive and allowed to cure to form a repositionablefilm. The adhesive and film are transparent, allowing the user tomonitor the course of wound healing by visual inspection.

EXAMPLE 3

A patient had multiple wounds. One wound was treated by applying asurgical mesh having a curing accelerator (for accelerating the curingof cyanoacrylates) over the wound. An octylcyanoacrylate skin adhesivewas applied over the mesh. The resultant glue/mesh composite formedwell-supported wound seal, but was intensely uncomfortable for thepatient. The patient requested that the composite be removed, however,such removal was not possible because the composite was strongly adheredto the patient's skin such that tearing it off would reopen the wound.

EXAMPLE 4

A second wound on the same patient described in Example 3 was sealedwith an octylcyanoacrylate skin adhesive, which was allowed to cure. Arepositionable nonwoven film containing an antimicrobial and siliconskin adhesive (sold under the name Optifoam® Gentile AntimicrobialPost-Op Strip) was affixed over the cured octylcyanoacrylate adhesive.The patient reported a high level of comfort with this system, which didnot overly restrict patient movement.

The various embodiments described herein allow a person of ordinaryskill in the art to make, use, and practice the invention. However, suchembodiments are not intended to be limiting, unless otherwise specified.For example, while various specific surgically acceptable adhesives andfilms have been described for illustrative purposes, such specificelements are not intended to be limiting. Indeed, a person of ordinaryskill in the art will find variations, substitutions, and changes thatare within the spirit and scope of the invention.

We claim:
 1. A wound management system, comprising a surgicallyacceptable skin adhesive disposed over and in direct contact with awound; and a surgically acceptable film repositionably disposed over thesurgically acceptable skin adhesive, wherein both the surgicallyacceptable skin adhesive and the surgically acceptable film cover thewound.
 2. The wound management system of claim 1, wherein the surgicallyacceptable skin adhesive is a cyanoacrylate adhesive.
 3. The woundmanagement system of claim 2, wherein the surgically acceptable skinadhesive comprises at least one of butylcyanoacrylate andoctylcyanoacrylate.
 4. The wound management system of claim 3, whereinthe surgically acceptable adhesive comprises octylcyanoacrylate.
 5. Thewound management system of claim 1, wherein the surgically acceptablefilm is in contact with the surgically acceptable skin adhesive.
 6. Thewound management system of claim 5, wherein the surgically acceptablefilm comprises a first side and a second side, the first side having apressure sensitive adhesive disposed thereon.
 7. The wound managementsystem of claim 1, wherein the surgically acceptable film comprises asilicone sheet.
 8. The wound management system of claim 1, wherein thesurgically acceptable film comprises a silicone adhesive.
 9. The woundmanagement system of claim 1, wherein the surgically acceptable film isformed by disposing a curable gel or curable liquid over the surgicallyacceptable skin adhesive and curing the curable gel or curable liquidinto a film.
 10. The wound management system of claim 1, wherein thesurgically acceptable film is permeable to at least one of air,moisture, blood, and wound exudate.
 11. The wound management system ofclaim 1, wherein the surgically acceptable film is semi-permeable to atleast one of air, moisture, blood, and wound exudate.
 12. The woundmanagement system of claim 1, wherein the surgically acceptable film isimpermeable to at least one of air, moisture, blood, and wound exudate.13. The wound management system of claim 1, wherein the surgicallyacceptable film is transparent or translucent.
 14. The wound managementsystem of claim 1, wherein the surgically acceptable film is opaque. 15.The wound management system of claim 1, wherein the surgicallyacceptable film is adapted to change from transparent or translucent toopaque.
 16. The wound management system of claim 1, wherein thesurgically acceptable film is in the form of a surgically acceptabletape, dressing or bandage.
 17. The wound management system of claim 1,wherein the surgically acceptable adhesive is an atraumatic adhesive.18. The wound management system of claim 1, wherein the surgicallyacceptable film comprises one or more of silicone, paper, cellulose,microporous material, polyamide, and polyacrylate, polyester,copolyester, and fabric.
 19. The wound management system of claim 18,wherein the surgically acceptable film comprises silicone.
 20. The woundmanagement system of claim 19, wherein the surgically acceptable filmhas a first surface comprising silicone and a second surface comprisingone or more of paper, cellulose, microporous material, polyamide, andpolyacrylate, polyester, copolyester, and fabric.
 21. The woundmanagement system of claim 1, wherein the surgically acceptable film isperforated.
 22. The wound management system of claim 1, wherein thesurgically acceptable film is not perforated.
 23. The wound managementsystem of claim 1, further comprising an absorbent dressing disposedover the surgically acceptable film.
 24. The wound management system ofclaim 1, further comprising at least one topically administrable activeagent.
 25. The wound management system of claim 24, wherein thetopically administrable active agent comprises one or more ofantimicrobials, moisturizers, vitamins, skin nutrients, beneficial oils,and scar reducing agents.
 26. The wound management system of claim 1,wherein the surgically acceptable film comprises one or more markingsdelineating one or more pre-determined shapes on the film.
 27. The woundmanagement system of claim 3, wherein the surgically acceptable skinadhesive has an amount from about 0.1 mL to about 10 mL.